Coverage of Conditions and Treatments (Coverage Decisions)

Use this lookup tool to determine coverage decisions, or if prior authorization is needed for the treatment or condition. Note: For Self-insured employer claims, you must contact the employer or their claims administrator.

List also available in PDF format.

Archived Coverage Decisions.

See Treatment Guidelines and Resources for additional information.

Occupational Health Best Practices and L&I header

Quantitative sensory testing is a subjective, psychophysical test developed to assess sensory nerve function and measures the level at which a subject reports sensing a physical stimulus (detection threshold) applied to the skin. It differs from standard electrodiagnostic testing using nerve conduction studies, evoked potentials, or electromyography, which objectively measures neurological function.

Coverage decision

The department or self-insurer does not cover use of quantitative sensory testing (QST) for the purpose of diagnosing, treating, or following patients for any condition. Diagnoses based solely or primarily on QST test results will not be accepted as allowed conditions on a Workers’ Compensation or Crime Victims’ claim. The department or self-insured employer will not pay for follow-up treatment recommended by the provider in response to QST test results.

Noncoverage of QST includes, but is not limited to, use of sensory nerve conduction threshold testing (sNCT), current perception threshold testing (including current-input and voltage-actuated or similar devices, e.g., Neurometer® CPT, Neural-Scan™, Axon II™, Medi-Dx 7000™), and testing using the NK Pressure Specified Sensory Device (PSSD).

Background Policy Information

QST was developed to assess sensory nerve function and measures the level at which a subject reports sensing a physical stimulus (detection threshold) applied to the skin. QST is a subjective, psychophysical test requiring an alert and cooperative patient. It differs from standard electrodiagnostic testing using nerve conduction studies, evoked potentials, or electromyography which objectively measures neurological function.

Some sensory nerve evaluation techniques (e.g., Semmes Weinstein monofilaments, tuning forks) are routinely used during clinical exams; this policy is not meant to discourage their use; however, L&I considers such use part of the routine clinical exam and not a separate payable service.

Review by the Industrial Insurance Medical Advisory Committee (IIMAC)

A health technology assessment of QST was presented to the IIMAC on July 23, 2009. Based on this review of the best available scientific literature the IIMAC advised non-coverage of QST.

Billing Codes

The following codes are not payable:

  • CPT®
    • 0106T - Quantitative sensory testing (QST), testing and interpretation per extremity; using touch, pressure stimuli, to assess large diameter sensation
    • 0107T - Quantitative sensory testing (QST), testing and interpretation per extremity; using vibration stimuli, to assess large diameter sensation
    • 0108T - Quantitative sensory testing (QST), testing and interpretation per extremity; using cooling stimuli to assess small nerve fiber sensation and hyperalgesia
    • 0109T - Quantitative sensory testing (QST), testing and interpretation per extremity; using vibration stimuli, to assess large diameter sensation
    • 0110T
  • HCPCS - G0255